German Chamomile

Last Editorial Review: 6/11/2021
Other Name(s):

Blue Chamomile, Camomèle, Camomilla, Camomille, Camomille Allemande, Camomille Sauvage, Camomille Tronquée, Camomille Vraie, Chamomile, Chamomilla recutita, Echte Kamille, Feldkamille, Fleur de Camomile, Hungarian Chamomile, Kamillen, Kleine Kamille, Manzanilla, Manzanilla Alemana, Matricaire, Matricaire Camomille, Matricaria chamomilla, Matricaria recutita, Matricariae Flos, Œil du Soleil, Petite Camomille, Pin Heads, Sweet False Chamomile, True Chamomile, Wild Chamomile.

Overview

German chamomile is an herb that is native to southern and eastern Europe. The herb smells slightly like apple, and is popular throughout the world. The name "chamomile" is Greek for "Earth apple". Do not confuse German chamomile with Roman chamomile.

People take German chamomile by mouth for intestinal gas, travel sickness, stuffy nose, hay fever, diarrhea, attention deficit-hyperactivity disorder (ADHD), fibromyalgia, anxiety, restlessness, and trouble sleeping. It is also taken by mouth for stomach and intestinal spasms, stomach and intestinal inflammation, stomach ulcers, colic, indigestion, and menstrual cramps.

Some people apply German chamomile directly to the skin for hemorrhoids; breast soreness; leg ulcers; pressure ulcers; allergic skin irritation; and bacterial skin diseases, including those of the mouth and gums. It is also used on the skin for treating or preventing damage to the inside of the mouth caused by chemotherapy or radiation; to treat skin breakdown around colostomy appliances, and skin rash.

A form of German chamomile that can be inhaled is used to treat inflammation (swelling) and irritation of the respiratory tract and the common cold.

In foods and beverages, German chamomile is used as flavoring.

In manufacturing, German chamomile is used in cosmetics, soaps, and mouthwashes.

How does it work?

German chamomile contains chemicals that seem to promote relaxation and reduce swelling (inflammation).

Researchers aren't sure which chemicals in German chamomile might cause relaxation.

German chamomile might reduce swelling by slowing the production of chemicals called prostaglandins, leukotrienes, and histamines. These chemicals are usually released to create a swelling response in the body.

QUESTION

GERD is the back up of stomach acid into the esophagus. See Answer

Uses & Effectiveness

Possibly Effective for...

  • Anxiety. Research suggests that taking capsules containing 220 to 1100 mg of 220-1110 mg of German chamomile extract daily for 8 weeks reduces anxiety and depression in adults with generalized anxiety disorder.
  • Colic. Research shows that a specific product containing fennel, lemon balm, and German chamomile (ColiMil, Milte Italia SPA), taken twice daily for one week, reduces crying in breast-fed infants with colic. Other research shows that a specific herbal tea (Calma-Bebi, Bonomelli, Dolzago, Italy) containing German chamomile, vervain, licorice, fennel, and lemon balm, taken up to three times daily after each episode of colic for 7 days, helps eliminate colic in some infants. However, it doesn't seem to reduce the number of nighttime awakenings.
  • Diarrhea. Taking a product containing apple pectin and German chamomile (Diarrhoesan, Dr. Loges + Co. GmbH, Winsen, Germany) for 1-3 days seems to reduce diarrhea in children 6 months to 6 years old.
  • Heartburn (dyspepsia). Research suggests that taking two specific combination products containing German chamomile and other ingredients (Iberogast, Steigerwald Arzneimittelwerk GmbH; STW-5-S, Steigerwald Arzneimittelwerk GmbH) improves symptoms of heartburn. Also, using another combination product containing German chamomile and other ingredients (STW 5-II, Steigerwald Arzneimittelwerk GmbH) improves heartburn by 40% when compared to a placebo treatment.

Possibly Ineffective for...

  • Skin irritation (dermatitis). Applying German chamomile cream (Kamillosan, AP Medical AB, Stockholm, Sweden) to the skin does not seem to prevent skin irritation caused by cancer radiation therapy.

Insufficient Evidence to Rate Effectiveness for...

  • Common cold. Early research suggests that dissolving a German chamomile product (Kneipp Kamillen-Konzentrat, Kneipp Werke) in hot water and inhaling the steam for 10 minutes reduces common cold symptoms.
  • Inflamed or irritated skin (eczema). Some research shows that applying a cream containing 2% German chamomile extract (Kamillosan, Asta Medica AG) to the skin improves inflamed or irritated skin. In fact, it might work better than creams containing 0.75% fluocortin butyl ester or 5% bufexamac. However, other research shows that applying a cream containing 10% German chamomile extract does not improve inflamed or irritated skin. The differences in effectiveness might be related to differences in creams used and the severity of eczema in patients.
  • Gum disease. Research shows that using an herbal toothpaste containing German chamomile, sage, myrrh eucalyptus, calcium carbonate, and sodium monoflurophosphate twice daily for 30 days reduces gum disease compared to pretreatment. But it doesn't appear to work better than standard toothpaste.
  • Hemorrhoids. Early research shows that applying German chamomile ointment (Kamillosan, Asta Medica AG) together with standard treatment improves bleeding, itching, and burning in people with hemorrhoids.
  • Insomnia. Research shows that taking German chamomile twice daily for 28 days does not improve sleeping problems in people with insomnia.
  • Swelling and deterioration of the mouth lining (oral mucositis). Using a German chamomile mouth rinse (Kamillosan Liquidum, Asta Media AG) might help prevent or treat swelling or deterioration of the mouth lining caused by radiation therapy and some types of chemotherapy. However, it doesn't appear to prevent swelling and deterioration of the mouth lining caused by 5-fluorouracil.
  • Skin breakdown around colostomy appliances (peristomal lesions). Early research shows that applying a German chamomile compress to areas of skin breakdown around colostomy appliances decreases the amount of time needed for skin lesions to heal by about 5 to 6 days compared to applying 1% hydrocortisone cream.
  • Vaginal infection (vaginitis). Early research shows that flushing the vagina with a German chamomile extract in water reduces symptoms such as odor and swelling in women with vaginal infections.
  • Wound healing. Research shows that applying a German chamomile product (Kamille Spitzner, W. Spitzner Arzneimittelfabrik GmbH) to wounds for 14 days reduces wound size after 4 days of treatment but does not affect wound healing approximately 3 weeks after tattoo removal.
  • Attention deficit-hyperactivity disorder (ADHD).
  • Fibromyalgia.
  • Hay fever.
  • Intestinal gas.
  • Menstrual cramps.
  • Nasal swelling (inflammation).
  • Restlessness.
  • Stomach and intestinal disorders.
  • Travel sickness.
  • Other conditions.
More evidence is needed to rate the effectiveness of German chamomile for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

German chamomile is LIKELY SAFE when taken in amounts found in food. In fact, it has "Generally Recognized as Safe (GRAS)" status in the U.S. German chamomile is POSSIBLY SAFE when taken by mouth as a medicine for short periods of time (up to 8 weeks). German chamomile has also been applied to the skin of adults for short periods of time. The long-term safety of German chamomile is unknown.

German chamomile can cause allergic reactions in some people when taken by mouth. It is in the same plant family as ragweed, marigolds, daisies, and other related herbs.

When applied to the skin, German chamomile can cause allergic skin reactions. When applied near the eyes, German chamomile may cause eye irritation.

SLIDESHOW

Digestive Disorders: Common Misconceptions See Slideshow

Special Precautions & Warnings

Children: German chamomile is POSSIBLY SAFE when taken by mouth appropriately, short-term. Early research shows that several products containing German chamomile are safe in infants when used for up to one week.

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking German chamomile if you are pregnant or breast feeding. Stay on the safe side and avoid use.

Allergies to ragweed or related plants: German chamomile may cause an allergic reaction in people who are sensitive to the Asteraceae/Compositae family of plants. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs.

Hormone-sensitive condition such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: German chamomile might act like estrogen in the body. If you have any condition that might be made worse by exposure to estrogen, don't use German chamomile.

Surgery: German chamomile might interact with anesthesia for surgery and should not be used 2 weeks before surgery.

Interactions


Birth control pills (Contraceptive drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some birth control pills contain estrogen. German chamomile might have some of the same effects as estrogen. However, German chamomile isn't as strong as the estrogen in birth control pills. Taking German chamomile along with birth control pills might decrease the effectiveness of birth control pills. If you take birth control pills along with German chamomile, use an additional form of birth control such as a condom.

Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.


EstrogensInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Large amounts of German chamomile might have some of the same effects as estrogen. However, large amounts of German chamomile aren't as strong as estrogen pills. Taking German chamomile along with estrogen pills might decrease the effects of estrogen pills.

Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.


Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. German chamomile might decrease how quickly the liver breaks down some medications. Taking German chamomile along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking German chamomile, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.


Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. German chamomile might decrease how quickly the liver breaks down some medications. Taking German chamomile along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking German chamomile, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil); antipsychotics such as haloperidol (Haldol), risperidone (Risperdal), and chlorpromazine (Thorazine); beta-blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), and carvedilol (Coreg); tamoxifen (Nolvadex); and others.


Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. German chamomile might decrease how quickly the liver breaks down some medications. Taking German chamomile along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking German chamomile, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.


Sedative medications (Benzodiazepines)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

German chamomile might cause sleepiness and drowsiness. Drugs that cause sleepiness and drowsiness are called sedatives. Taking German chamomile along with sedative medications might cause too much sleepiness.

Some of these sedative medications include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), triazolam (Halcion), and others.


Sedative medications (CNS depressants)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

German chamomile might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking German chamomile along with sedative medications might cause too much sleepiness.

Some sedative medications include pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), fentanyl (Duragesic, Sublimaze), morphine, zolpidem (Ambien), and others.


Tamoxifen (Nolvadex)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some types of cancer are affected by hormones in the body. Estrogen-sensitive cancers are cancers that are affected by estrogen levels in the body. Tamoxifen (Nolvadex) is used to help treat and prevent these types of cancer. German chamomile seems to also affect estrogen levels in the body. By affecting estrogen in the body, German chamomile might decrease the effectiveness of tamoxifen (Nolvadex). Do not take German chamomile if you are taking tamoxifen (Nolvadex).


Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. German chamomile might increase the effects of warfarin (Coumadin). Taking German chamomile and warfarin (Coumadin) together might slow blood clotting too much and cause bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.


Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. German chamomile might decrease how quickly the liver breaks down some medications. Taking German chamomile along with some medications that are broken down by the liver can increase the effects and side effects of these medications. Before taking German chamomile, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others.

Dosing

The following doses have been studied in scientific research:

ADULT:

BY MOUTH:

  • For anxiety: Capsules containing 220-1100 mg of German chamomile extract have been taken daily for 8 weeks.
  • For heartburn (dyspepsia): 1 mL of a specific product containing licorice, milk thistle, peppermint leaf, German chamomile, caraway, celandine, angelica, lemon balm, and clown's mustard plant (Iberogast; Steigerwald Arzneimittelwerk GmbH) has been taken three times daily for 4 weeks. Also, 1 mL of another specific product containing licorice, milk thistle, peppermint leaf, German chamomile, caraway, celandine, angelica, and lemon balm (STW-5-S, Steigerwald Arzneimittelwerk GmbH) has been taken three times daily for 4 weeks. In addition, 1 mL of a specific product containing clown's mustard plant, German chamomile, peppermint, caraway, licorice, and lemon balm (STW 5-II, Steigerwald Arzneimittelwerk GmbH) has been taken three times daily for up to 12 weeks.
CHILDREN:

BY MOUTH:

  • For colic: A product containing 164 mg of fennel, 97 mg of lemon balm, and 178 mg of German chamomile (ColiMil, Milte Italia SPA) has been taken twice daily for one week. A 150 mL dose of an herbal tea (Calma-Bebi, Bonomelli, Dolzago, Italy) containing extracts of German chamomile, vervain, licorice, fennel, and lemon balm, has been taken up to three times daily after each episode of colic for 7 days.
  • For diarrhea: A specific product (Diarrhoesan, Dr. Loges + Co. GmbH, Winsen, Germany) containing apple pectin and German chamomile extract has been used for 1-3 days in children 6 months to 6 years old.

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